Annals of Occupational and Environmental Medicine

Original article

Association between relative handgrip strength and glycemic control among male automobile manufacturing workers using vibration tools in South Korea: Dong-jae Seo, Hyun Joong Kim, Yongjin Kim, Jaewon Mun, Jong-Han Leem, Shin-Goo Park, Dong-Wook Lee, Hwan-Cheol Kim; Ann Occup Environ Med 2026;e14. Published online April 8, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e14 [Accepted]

Abstract PDF: Background
Although the association between handgrip strength and glycemic control has been reported, studies conducted exclusively within specific occupational groups remain limited. To explore the association between handgrip strength and metabolic health in industrial settings, this study examined the relationship between relative handgrip strength and glycated hemoglobin (HbA1c) among male automobile manufacturing workers using vibration tools in South Korea.
Methods
Using 66,212 occupational health examination records collected at Inha University Hospital between January 2024 and April 2025, a total of 3,365 workers with HbA1c and handgrip strength measurements were identified. After excluding duplicates (n = 1,536), female workers (n = 2), and records without Hb and eGFR, 1,823 male participants were included in the final analysis. Relative handgrip strength was calculated as the maximum value of bilateral grip strength divided by body mass index. Multiple linear regression analyses were conducted to assess the association between relative handgrip strength and HbA1c, adjusting for age, smoking status, alcohol consumption, current hypertension, current dyslipidemia, current hypoglycemic-agents use, family diabetes history, leisure-time physical activity, and resistance exercise.
Results
Relative handgrip strength was inversely associated with HbA1c levels (B: –0.060; 95% confidence interval [CI]: −0.081 to −0.039; p < 0.001). The association was strongest among normoglycemic participants (B: −0.185; 95% CI: −0.305 to −0.065; p = 0.003). Effect size was reduced but significantly associated among individuals with prediabetes (B: −0.115; 95% CI: −0.180 to −0.050; p < 0.001) and further attenuated to a borderline significance in individuals with diabetes (B: −0.023; 95% CI: −0.050 to 0.003; p = 0.082). These findings indicate that greater muscle strength relative to body size is related to better glycemic control.
Conclusions
Handgrip strength was associated with HbA1c levels in industrial workers. This study suggests that handgrip strength may provide complementary information on metabolic health in occupational settings.

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Original Article

Association between heavy metal exposure and high-sensitivity C-reactive protein in the elderly: Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2017: Jongwon Jung, Ji Young Ryu; Ann Occup Environ Med 2026;e13. Published online April 6, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e13 [Accepted]

Abstract PDF: Background
Cardiovascular diseases (CVDs) are a primary cause of mortality in the elderly. Exposure to heavy metals such as lead, cadmium, and mercury has been suggested to increase CVD risk by inducing reactive oxygen species and inflammatory responses. The elderly are particularly susceptible to heavy metal exposure, which may increase their CVD risk. Despite this potential risk, evidence specifically focusing on the association between blood heavy metal levels and high-sensitivity C-reactive protein (hsCRP), a key predictor of CVDs, in the elderly remains limited. Therefore, the present study aimed to assess the relationship between blood lead, mercury, and cadmium concentrations and hsCRP in the elderly.
Methods
We analyzed 884 subjects (385 men, 499 women) aged 65 years and older without CVD history from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2017. Because KNHANES is a two-stage stratified clustered sample, all analyses applied stratum, cluster, and weight. Estimated geometric means (GMs) of hsCRP across demographic factors and heavy metal quartiles were compared using a complex samples general linear model (CSGLM). The association between blood heavy metals and hsCRP was examined using CSGLM, adjusting for age, sex, body mass index, estimated glomerular filtration rate, smoking status, alcohol consumption, education, physical activity, monthly income, and underlying diseases.
Results
The estimated GM of hsCRP differed significantly by blood lead quartile (p = 0.035) and showed a significant increasing trend (p for trend = 0.019). In CSGLM analysis, elevated blood lead concentrations were significantly associated with increased hsCRP (β = 0.176, p = 0.032) after adjustment. However, blood mercury and cadmium concentrations showed no significant associations with hsCRP.
Conclusions
The observed association between blood lead concentrations and hsCRP suggests that elevated blood lead may contribute to increased CVD risk in the elderly. Given the susceptibility of this population, subsequent investigations are warranted to confirm this association and develop preventive strategies.

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Original Article

Occupational Diseases in Mongolia: A Retrospective Analysis (1975–2023) with a 30-Year Trend Study: Sansartsetseg Tsendjav, Myagmarchuluun Sainnyambuu, Otgonbayar Damdinbazar, Ulzii-Orshikh Ragchaabazar, Gantugs Yundendorj; Ann Occup Environ Med 2026;e12. Published online March 24, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e12 [Accepted]

Abstract PDF: Background
Occupational diseases represent a significant global public health challenge, yet reliable data from transitioning economies remain limited. This study aimed to analyze newly confirmed occupational disease cases in Mongolia over a 50-year period (1975–2023), identifying long-term trends and the prevalence of leading disease categories.
Methods
A retrospective, record-based study was conducted using quantitative data from 10,233 officially confirmed and compensated cases of occupational diseases resulting in an officially certified loss of labor capacity. Incidence rates per 100,000 workers were calculated for the 1992–2023 period. Leading diseases were classified by organ system, with focused analyses on respiratory diseases, occupational poisonings, and neurological disorders.
Results
Dust- and particulate-induced respiratory diseases accounted for the largest proportion of cases (57.3%), followed by occupational neurological disorders (16.2%) and occupational poisonings (7.9%). From 1992 to 2023, incidence rates among male workers were consistently 3–7 times higher than those among female workers. Analysis of exposure duration showed mean durations of 13.6 ± 4.9 years for silicosis (J62) and 20.7 ± 10.7 years for inorganic substance poisoning (T52). While respiratory diseases predominant historically, cases of occupational neurological diseases increased 1.9-fold after 2015.
Conclusions
Occupational neurological disorders are showing an increasing trend in Mongolia, reflecting a shift in the national occupational disease pattern. However, as the registry is based on the national compensation framework, these findings likely reflect recognized cases rather than the true epidemiological incidence, suggesting potential underreporting. Strengthening surveillance beyond the compensation system and improving diagnostic capacity for a broader range of work-related conditions are essential for effective prevention and policy development.

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